Inspection on 07/09/09 for Melrose House

This is the latest available inspection report for this service, carried out on 7th September 2009.

CQC found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Melrose House 20/02/06

Melrose House 28/10/04

Melrose House 21/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Melrose House 41a Muswell Avenue Muswell Hill London N10 2EH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Shamash     Date: 0 7 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Melrose House 41a Muswell Avenue Muswell Hill London N10 2EH 02084448483 02084448483 rford81128@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Richard John Ford care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Melrose House is a care home registered to provide personal care for six service users who have mental health problems. It has been operating for a number of years. This is a family run home, with the registered proprietor/manager and his family providing the main support system for service users. Care practice is focused on promoting levels of independence that service users are comfortable with and that enables them to have a quality of life that they enjoy. The home is a large first floor maisonette that has been converted to use as a care home. There are spacious communal areas consisting of a lounge/dining area, a kitchen that is large enough to accommodate a table and chairs for informal meals and a more private sitting area located on the upper floor/ Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Brief description of the care home office area and sleeping room. There is a large garden to the rear of the home. There are two double bedrooms and three single bedrooms, a bath/shower room with toilet, shower room and two separate toilets. There is also a laundry area, which stores a washing machine and dryer, space for ironing and a separate shower unit with toilet and washbasin. The home has been recently decorated to a high standard. The home is located in a residential street close to the shops, services and businesses in Muswell Hill and local transport links. Inspection reports produced by the CQC are available upon request from the registered manager/provider. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was completed over two days, on the 7th September and 17th September 2009, lasting approximately seven hours. The registered provider/manager and the deputy assisted the inspector throughout the inspection. I had the opportunity to meet with all six residents during the inspection, with three residents at home at the start of the inspection, and others returning later in the day. The inspection involved sampling care plans, policies and procedures, staff records,health and safety records and other records relating to the day to day running of the home. All residents were spoken to, and I had the opportunity to meet all three staff members. A tour of the building was conducted and observations were made of interactions between staff and residents, and individual residents within the home. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service considers the needs assessment for each prospective resident carefullybefore agreeing admission to the home, and all prospective residents have the opportunity to visit and stay at the home prior to deciding whether to stay at the home. Therefore people know that their care needs will be met by the home. Evidence: Melrose House is a care home registered to provide personal care for six people who have mental health problems. The home started as a board and lodging accommodation for people with mental health needs in the early 1980s and some of the residents have lived in the home since then. Residents speak highly about the standard of care provided in the home, and this has been maintained to a high standard with regards to individual care and support needs, over many years. Discussion with the manager, inspection of assessments and care plans, and discussion with residents indicated that the home is able to meet the needs of all people accommodated. The manager advised that a part of the agreement on Care Homes for Adults (18-65 years) Page 9 of 28 Evidence: admission remains that this home is a home for life, and he has supported this for each person living at the home. Three service user files were inspected and each contained a detailed assessment for each resident prior to their moving into the home, including an assessment regarding self-medication for the most newly admitted resident. Information from care coordinators including minutes of the most recent Care Programme Approach (CPA) meetings, and Occupational Therapy assessments where relevant, were also available for each person prior to admission. Discussion with the most recent person to move into the home indicated that they had had the opportunity to visit and stay at the home prior to deciding on whether to remain at the home on a permanent basis. They felt that they had been provided with sufficient information about the home, and that they had been fully involved in the admissions assessment conducted prior to moving in. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home make decisions about their lives with assistance as needed, and are supported to take risks as part of their independence. Evidence: Three care plans were inspected, including that of the most recently admitted resident. These were generally found to be detailed, and up to date, taking into account the care, support and changing needs of the individual people living in Melrose House. Each had been signed by the relevant resident, with the exception of one, for which the identified resident advised that they preferred not to sign any documents. However inspection of the care plans alongside the contents of care-coordinator reviews, indicated that there is room for further development of the care plans to reflect peoples progress made in working towards identified goals. There is also room for more detailed recording of peoples preferences for personal care including areas in which they are independent. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: Evidence was available that review meetings are held at six-monthly intervals by the home and yearly with the placing authorities. With respect to a resident identified at the previous inspection, the manager advised that they had arranged an additional care review meeting, following changes in that persons physical dependency. Risk assessments were available for each resident, regarding relevant issues including smoking, budgeting, self-medicating, going out alone, diabetes and mental health state management. Care plans took account of peoples mobility and personal care needs, and were reviewed at least six-monthly for peopl under sixty-five and monthly for those over the age of sixty-five. Discussion with the manager and deputy indicated that staff respect peoples wishes and their rights to make decisions. Residents confirmed that they are kept informed of any changes through meetings or general discussions, about the home, and their care and support. The home has a strong ethos of involving residents in all aspects of their life, including cleaning their rooms, making snacks, encouraging hobbies, contact with family members etc. and this was evident through the care plans, speaking to residents and the contents of review meetings. Care Homes for Adults (18-65 years) Page 12 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities for personal development and are encouraged to be involved within the local community on a daily basis. They are supported to maintain contact with family and friends, and have the opportunity to attend leisure pursuits. The meals served within the home are of a high standard, offering choices and variety, and catering for particular dietary needs. Evidence: Residents are engaged in a variety of day activities during the working week, including attendance of day centres, a supported employment workshop in Haringey, going out and about within the local community. One person prefers to stay at home and is not interested in any structured day activities. The most newly admitted resident told me that they intended to enrol on a college course, and were also looking for paid employment. It is recommended that a computer with internet access be made available for people living at the home with appropriate support to use this medium. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: On the first day of this inspection, three residents were at home, and I spoke to them as they were either sitting in the lounge or in their bedrooms. Alll (except one person who told me that they did not like to go out) go out regularly within the local community, visiting shops, cafes and pubs in the local vicinity, with bus passes enabling them to travel freely. Residents advised that they knew the local shops, supermarkets and cafes well, and have a good relationship with their neighbours. The manager advised that over the past year, residents had been on planned trips out to Paradise Park Wildlife Centre in Broxbourne, and visits to parks and garden centres. A short holiday was also arranged for residents at Hayling Island. Occasional parties are held at the home, and a barbeque was arranged over the summer. Further events are planned for the coming year. The manager advised that there are no restrictions on visitors, and that relationships outside of the home are encouraged. However few residents currently have significant contacts outside of the home. One residents family members visit occasionally, and evidence of this was seen within the visitors logbook. Residents spoken to advised that the food available in the home was of good quality, and varied. A current menu was on display indicating that well balanced, varied and nutritious foods are served in the home, and the home was well stocked with fresh ingredients. On Sunday evenings staff and residents prepare a menu for the week ahead. However the menu did not include alternatives provided for individual residents such as a vegetarian resident, nor what was provided for lunch for residents remaining within the home. The manager advised that peoples cultural needs with regards to meals are addressed alongside for a vegetarian diet, and the needs of a a diabetic resident. Appropriate stocks of fresh fruit and vegetables were available within the kitchen, and foods in the refrigerator and freezer were found to be stored and labelled appropriately. One resident advised that they continue to enjoy cooking in the home with support from staff members, however others seemed less clear that the they could utilise the kitchen whenever they wished to. This issue is addressed under Standard 37. Care Homes for Adults (18-65 years) Page 14 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support at the home is offered to a high standard, in such a way as to promote and protect peoples privacy, dignity, healthcare needs and independence. The medication for people living at the home is well managed, promoting peoples health appropriately. Evidence: The manager stated that the majority of residents are very independent and need relatively low levels of support with personal care, with the exception of some support with bathing or showering. The manager advised that personal care needs are addressed by having a male and female carer on shift when peoples personal needs require it. The management had put in place a clear continence plan for an identified person who needed support in this area, and advised that this persons needs had decreased in this area more recently, following intensive support, for which the home is commended. There was evidence within peoples care files, that they have access to local primary Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: care services and specialist mental health services. The manager advised that the practice nurse from the GP practice also carries out an annual health check. Separate records of each persons medical conditions were available, and there was evidence that ongoing medical problems were being recorded appropriately within the care plans. The home has a good working relationship with the local GP surgery, and records indicated that all residents had been supported to see their GP, and other healthcare professionals as appropriate. The home is commended for a high level of support provided to residents in meeting their health needs. Medication policies and procedures were found to be in good order. The manager has a good knowledge and awareness of current legislation regarding peoples prescribed medication. Storage arrangements were appropriate, and medication administration records were complete and up to date. All residents self-medicate on a daily basis, and the manager advised that it might be possible for one resident to manage more of their medication independently in time. It is recommended that the pharmacist be consulting regarding dispensing a particular medicine into a daily dossett box, in order to ensure that this is in line with best practice. Care Homes for Adults (18-65 years) Page 16 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be sure that their views are listened to and acted upon. They are protected and safeguarded by staff that are trained appropriately. Evidence: Appropriate complaints and safeguarding adults policies and procedures are in place for the home. These remain robust, comprehensive and clear. The abuse policy reflects the local authoritys adult protection procedures and no allegations or concerns of abuse have come to light since the previous inspection. A record of complaints was available for the home, and three complaints were recorded since the previous inspection, including details of action taken to address each issue indicating that these were addressed swiftly, and that peoples concerns were taken seriously. A number of compliments were also recorded for the home from people who had visited the establishment. The complaints procedure posted in the corridor on the first floor of the home contained outdated contact details for the regulatory authority, and needed to be updated to include the CQCs contact details. All staff had undertaken Safeguarding Adults training, and certificates were seen to evidence this. However it is recommended that one of the managers undertake the local authoritys own Safeguarding Adults training, when possible. The manager advised that he had not yet been successful, despite contacting Haringey on a number of occasions, to undertaken this training. Residents spoken to were confident that they Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: would be protected by the homes procedures, and that their concerns would be taken into account. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is decorated, furnished, and maintained to a very high standard, providing a clean, safe, comfortable and homely environment for residents. Evidence: Melrose House is a three-storey town house in the Muswell Hill area. Bedrooms consist of two double and three single bedrooms. All bedrooms examined are provided with comfortable furniture and fittings suitable to meet individual needs and lifestyles in the home. The double rooms are adequately sized to accommodate people sharing, ensuring that their privacy and dignity is upheld. On both days of the inspection, the home was comfortable, warm, bright, clean and inviting providing a homely atmosphere. People living at the home confirmed that this was their experience on a day to day basis. The home has a programme of redecoration and maintenance to ensure that it continues to be maintained to a high standard. Redecoration undetaken included, new wallpaper, carpets, curtains, furniture and fittings. Each room examined was homely and comfortable. The manager advised that residents are consulted with regards to the redecoration Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: programme and this was confirmed by those spoken to. The laundry room on the top floor had been refurbished alongside provision of an additional shower room for the use of residents. There is a large rear garden which was also maintained to a high standard, and included a covered area for the use of smokers. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported and protected by the homes recruitment policy and practices. They benefit from support provided by sufficient, competent and appropriately trained staff members. Evidence: Inspection of staffing rotas, discussion with staff and residents, and observation of routines within the home, indicated that the number of staffing hours and skills of staff members working in the home, meets the current requirements of the people accommodated. The manager takes the primary role in administrative work and is, responsible for medication recording and administration and care planning within the home. He advised that the deputy and support worker are particularly skilled at working directly with people both within groups and one to one interactions. However he advised that all staff have the necessary skills to be involved in care planning, administrative tasks and medication administration in his absence. All staff files were inspected, and were found to contain the required information as specified in Schedule 2 of the Care Homes Regulations 2001. Records of all training Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: undertaken by each staff member were available including all relevant mandatory trainin such as first aid, food hygiene, health and safety, fire safety, safeguarding adults, and medication training. Within the last year all staff had undertaken training in the Mental Capacity Act 2005, and Deprivation of Liberty safeguarding standards. All staff had experience and training in working with adults with mental health problems, however it is recommended that some current training be provided for staff, as a refresher and in order to update their skills. A comprehensive set of policies and procedures were also available within the office to guide and support staff. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is well qualified and experienced to run the home in the best interests of residents. The home benefits from an open and inclusive atmosphere, with a high standard of record keeping and appropriate quality assurance procedures. There is also a high standard of practice in promoting the health and safety of staff and residents. Evidence: Discussion with the manager indicated that he is very knowledgeable and experienced in managing the service effectively in the interests of residents. Discussion with residents likewise indicated that the management approach has generally created an open, positive and inclusive atmosphere. The home is homely, warm and inviting, which residents attribute to a family atmosphere within the service. However whilst several residents felt that they were part of the family, others indicated that they felt that they had to fit into the timetables of the homes management, e.g. as to when they could go to the kitchen for a drink, prepare a snack, or watch television. A recommendation is made accordingly. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The homes record keeping was found to be of a high standard, and well maintained. Residents files gave clear and comprehensive guidance to understanding individuals needs within the home. Discussion with the manager indicated a strong understanding of the equalities and diversity needs of individual residents, indicating that staff are confident in delivering high quality oucomes for people in the areas of race, ethnicity, age, sexuality, gender, disability and beliefs. There was evidence that an annual quality assurance audit is undertaken of the service, including distribution of questionnaires to residents, some relatives and health and social care professionals. There was also evidence that feedback from the audits were used to inform the business plan for the home. Regular residents meetings are held within the home and the minutes of these indicated that they were used to discuss a range of issues relating to the running of the home. Inspection of records relating to support provided to residents with their finances indicated that this was appropriate. Inspection of health and safety documentation indicated that there is a high standard of practice in this area including current gas and electrical installation certificates, portable appliances testing, and fire alarm, extinguishers and call point maintenance and testing documentation. An annual legionella test needs to be undertaken for the homes cold water storage, and the fire risk assessment should also be updated annually. Residents advised that the kitchen is kept locked at night. A risk assessment should be undertaken regarding this issue, with appropriate action taken as necessary, for the safety of residents, whilst promoting their independence as far as possible. A detailed flu pandemic plan had been produced for the home as appropriate, in the event of such an outbreak within the home. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 17 16 The registered person must ensure that the menu for the home includes details of lunch provided to people having this meal at the home, and that alternatives (e.g. vegetarian/cultural) to the evening meal are recorded for individual residents to evidence that they are receiving a diet of their choice. . 06/11/2009 2 42 13 The registered person must 27/11/2009 ensure that an annual legionella test is undertaken for the homes cold water storage, and that the fire risk assessment is updated annually. A risk assessment must be undertaken regarding whether it is necessary to keep the kitchen door locked at night, with appropriate action taken as necessary, for the Page 26 of 28 Care Homes for Adults (18-65 years) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action safety of residents, whilst promoting their independence as far as possible. . Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 It is recommended that care plans be updated to reflect more clearly progress made by individuals regarding their goals, and that more details regarding peoples preferences for personal care and areas in which they are independent. It is recommended that a computer with internet access be made available for people living at the home with appropriate support to use this medium. It is recommended that the manager obtain advice from the homes pharmacist, regarding secondarily dispensing Epilim into a dossett box on behalf of an identified reisdent, to ensure that this is a safe practice in terms of the efficacy of the medication. It is recommended that the complaints procedure posted on the first floor be updated to include the current contact details for the CQC. It is recommended that the manager or deputy enrol to undertake the local authoritys safeguarding adults training. It is recommended that current training in Mental Health Awareness be provided for staff within the home, to ensure that they work with residents in line with best practice. It is recommended that the management of the home undertake further and continued work to enhance residents perception of the service, as their home, rather than that of the management as far as possible. 2 12 3 20 4 22 5 6 23 35 7 38 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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